MEDICARE: ASHLEY LANE JANNEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME69202	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	080146875	OTHER	FL	RAIL ROAD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669413290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY LANE JANNEY M.D.

Provider Business Mailing Address
First Line	:	6721 THOMASVILLE RD
Second Line	:	SUITE 4
City	:	TALLAHASSEE
State	:	FL
Zip	:	32312-4875
Country	:	US
Telephone Number	:	850-431-9000
Fax Number	:	850-431-9001

Provider Business Practice Location Address
First Line	:	6721 THOMASVILLE RD
Second Line	:	SUITE 4
City	:	TALLAHASSEE
State	:	FL
Zip	:	32312-4875
Country	:	US
Telephone Number	:	850-431-9000
Fax Number	:	850-431-9001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	01/04/2017

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